The Healthcare Provider's #1 Medicare Audit Defense & Medicare Appeals Resource
Medicare Audit Defense & Compliance Tools - ZPIC Appeals - CMS Program Integrity Resources

Medicare Audits & Medicare Appeals Education - $159 Webcasts (*includes copy of presentation)

Join our industry-leading clinical documentation auditors, billing compliance professionals and legal support staff for the nation's best Medicare audits and Medicare appeals webcasts!  Call or e-mail us today for registration at support@zpicaudits.com or (303) 586-5003.

September 6, 2011 - 2:00pm - 3:00pm EST
CMS Appeals for Healthcare Providers - Applicability of the Treating Physician Rule & Other Legal Arguments

This presentation will address CMS efforts to stop Medicare fraud, Medicare audits, Medicare appeals and the applicability of the "treating physician rule".  CMS and a wide range of judicial findings have determined the relative weight to be given to attending physician testimony, Medicare coverage criteria, independent medical evidence and other issues in pending Medicare appeal matters.  With Medicare RAC audits, Medicare ZPIC audits and Medicaid Integrity Contractor audits (MIC audits) rolling out nationwide and 100,000s of Medicare appeals being anticipated annually, it is critical that providers understand prior Medicare Appeals Council and U.S. court findings relating to these very important issues.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than September 5.  You will receive an e-mail confirmation with sign-on information and password prior to September 6.  The cost is $159 per healthcare provider or health law attorney.

September 20, 2011 - 2:00pm - 3:00pm EST
Physician E&Ms / Wound Care Clinics / Emergency Room Visits - Use of Modifier 25

This presentation will address a key focus area that is rolling out nationwide on the permanent Medicare audit program - Physician Evaluation & Management services / Wound Care Clinic services / Emergency Room Visits - Use of Modifier 25.  Several previous CMS audits, error evaluations, probes and directives have highlighted a wide range of challenges regarding the accuracy of ER visit definitions.  This discussion will provide an in-depth look at physician evaluation & management coding, wound care clinic visits, ER visit definition, billing, claim submission requirements and the most recent CMS directives regarding modifier 25.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than September 19.  You will receive an e-mail confirmation with sign-on information and password prior to September 20.  The cost is $159 per healthcare provider and health law attorney.

October 4, 2011 - 2:00pm - 3:00pm EST
Managing the Risk of CMS Audits & CMS Appeals - Medicare & Medicaid (RAC Audits, OIG Audits, ZPIC Audits, MIC Audits & One PI)

This presentation will address the wide range of ongoing CMS efforts to stop Medicare fraud, Medicare audits & law enforcement fraud initiatives.  Congress has allocated an unprecedented level of financial resources to insuring adherence to Medicare coverage criteria by providers nationwide - Medicare RAC audits, Medicare ZPIC audits, etc.  Jackson Davis works closely with hospitals, physicians, inpatient rehabilitation facilities, skilled nursing facilities, home health agencies, hospices, HME suppliers and physical medicine groups facing day-to-day challenges of both responding to audit requests and managing the risk of potential Medicare fraud allegations.  This is a critical education session for provider executive management and physicians. 

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than October 3.  You will receive an e-mail confirmation with sign-on information and password prior to October 4.  The cost is $159 per healthcare provider or health law attorney.

October 18, 2011 - 2:00pm - 3:00pm EST
Short Stays - Chest Pain & Related Diagnoses (MS-DRG 312 & MS-DRG 313) - Inpatient or Observation?

This presentation will address the CMS payment criteria and Medicare coverage criteria for inpatient admission of Chest Pain and Chest Pain related cases presenting to the Emergency Room for care (primarily MS-DRG 312 and MS-DRG 313).  Short stays or the "inappropriate admission" of these diagnoses has been the leading focus for CMS probes, evaluations and claim challenges for the past 15 years.  This discussion will provide an in-depth look at implementing CMS admission criteria and the use of Case Management professionals in the Emergency Room.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than October 17.  You will receive an e-mail confirmation with sign-on information and password prior to October 18.  The cost is $159 per healthcare provider or health law attorney.

October 25, 2011 - 2:00pm - 3:00pm EST
Inpatient Rehabilitation Facility - 2011 CMS Payment Criteria

Detailed discussion of 2011 IRF Regulations - This presentation will address CMS Payment Criteria and Medicare Coverage Criteria for Inpatient Rehabilitation Facility admissions.  RAC audits recouped almost $60m in perceived overpayments from California IRF providers during the Medicare recovery audit demonstration and we will discuss the CMS "not so vague" concepts of IRF medical necessity, preadmission screening criteria and required clinical documentation.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than October 24.  You will receive an e-mail confirmation with sign-on information and password prior to October 25.  The cost is $159 per healthcare provider or health law attorney.

November 1, 2011 - 2:00pm - 3:00pm EST
Extensive OR Procedures Unrelated to Primary Diagnosis - MS-DRG 981 - 983

This presentation will address the CMS payment criteria for the appropriate submission of hospital claims being grouped to MSDRG 981 - 983 (extensive OR procedures unrelated to primary diagnosis).  Critical aspects of ICD-9 coding, HIS business rules and the claim submission process will all be discussed in detail.  This will be a great discussion for HIM leadership.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than October 31.  You will receive an e-mail confirmation with sign-on information and password prior to November 1.  The cost is $159 per healthcare provider or health law attorney.

November 8, 2011 - 2:00pm - 3:00pm EST
The CMS Appeals Process for Healthcare Providers - How the Game Has Changed

This presentation will address issues associated with Medicare audits / Medicare appeals - RAC appeals, ZPIC appeals, DOJ appeals, OIG appeals, MAC appeals, Medicare overpayment determinations and the Medicare appeals process.

As CMS continues to ramp up auditing efforts, providers nationwide are spending millions of dollars on legal fees, repaying tens of millions of dollars to CMS for conditional denials and being exposed to potential Medicare fraud allegations.  This discussion will provide an in-depth look at the Medicare appeals process and explore a wide range of opportunities for providers to proactively build winning Medicare appeals (RAC appeals, ZPIC appeals, etc.).  The old days of soft regulations and provider education are over - it is absolutely vital that providers understand how the game has changed.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than November 7.  You will receive an e-mail confirmation with sign-on information and password prior to November 8.  The cost is $159 per healthcare provider or health law attorney.

November 15, 2011 - 2:00pm - 3:00pm EST
Webcast - On the Medicare Audit Radar - HME Suppliers & Use of the KX Modifier

This presentation will address a key focus area that is on the permanent Medicare audits / ZPIC audits / MAC audits / RAC audits radar - HME supplies & the use of the KX modifier.  Multiple, recent Medicare audits and OIG investigations have highlighted a wide range of challenges regarding the appropriate use of and support for the KX modifier.  This discussion will provide an in-depth look at OIG investigation outcomes, MAC target areas, Medicare coverage criteria, NCD / LCD requirements, billing, claim submission requirements and the most recent CMS directives regarding modifier KX.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than November 14.  You will receive an e-mail confirmation with sign-on information and password prior to November 15.  The cost is $159 per HME supplier.

December 6, 2011 - 2:00pm - 3:00pm EST
Bringing It All Together - Medicare Audits, Evidence-Based Coverage, Value-Based Purchasing (VBP) & Pay-For-Performance (P4P)

This presentation will address Medicare's new reimbursement structure and how CMS is fitting all the pieces together.  FY 2011 has been a transformational year for providers and Medicare's EBM structure will be the biggest change to healthcare since the implementation of PPS almost 30 years ago.  This will be a great discussion for financial & executive leadership.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than December 5.  You will receive an e-mail confirmation with sign-on information and password prior to December 6.  The cost is $159 per healthcare provider or health law attorney.

December 20, 2011 - 2:00pm - 3:00pm EST
Skilled Nursing Facilities - Program Safeguard Contractors, RUG Assignment & Documentation

Under fire from Medicare ZPIC audits (as well as other CMS audit contractors), SNFs can be highly susceptible to losses from missing documentation, an inability to document acute stay requirements and challenges relating to appropriately billing MDS components for Medicare Part A coverage.  This presentation will address a wide range of topics including responding to Additional Documentation Requests from Program Safeguard Contractors, considering the applicability of acute stay documentation, performing self-audits and some of the major areas where providers struggle to support RUG level assignments.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than December 19.  You will receive an e-mail confirmation with sign-on information and password prior to December 20.  The cost is $159 per healthcare provider or health law attorney.

January 3, 2012 - 2:00pm - 3:00pm EST
Percutaneous Coronary Intervention (PCI) & ICD Surgical Procedures - Inpatient or Outpatient?

This presentation will address one of the primary Medicare audit focus areas and specifically considers CMS challenges to performing these surgical procedures in the "wrong setting".  Critical issues such as the Medicare Inpatient Only list, inpatient admitting criteria, documentation requirements and case management will all be discussed in detail.  This will be a great discussion for Case Management, HIM and financial staff.

Please send your registration request and contact information to us via e-mail at support@zpicaudits.com.  Registrations must be received no later than August 2.  You will receive an e-mail confirmation with sign-on information and password prior to January 1.  The cost is $159 per healthcare provider or health law attorney.